SERTOMA CENTRE, INC. (NPI# 1013240423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013240423 |
| Entity Type | Organization |
| Organization Name | SERTOMA CENTRE, INC. |
| Practice Address |
4331 Lincoln Hwy Suite A Matteson IL 60443-2404 |
| Mailing Address |
4343 W 123rd St Alsip IL 60803-1807 |
| Practice Telephone | 7087481951 |
| Practice Fax Number | 7087481962 |
| Mailing Telephone | 7083719700 |
| Mailing Fax Number | 7083719747 |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | MR. GUS VAN DEN BRINK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7083719700 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417431537 | Sertoma Centre, Inc. | Case Management | 4331 Lincoln Hwy Ste A, Matteson, IL 60443-2472 | 2018-09-25 |
| 1306170592 | Sertoma Centre, Inc. | Voluntary or Charitable | 4100 W 127th St, Alsip, IL 60803-1925 | 2009-09-22 |
| 1235241720 | Sertoma Centre, Inc. | Voluntary or Charitable | 4343 W 123rd St, Alsip, IL 60803-1807 | 2006-08-31 |
| 1982201414 | Sertoma Centre, Inc. | Clinic/Center | 4343 W 123rd St, Alsip, IL 60803-1807 | 2020-10-07 |
| 1194348359 | Sertoma Centre, Inc. | Voluntary or Charitable | 4100 W 127th St, Alsip, IL 60803-1925 | 2020-05-22 |
| Street Address |
4331 LINCOLN HWY SUITE A |
| City | MATTESON |
| State | IL |
| Zip Code | 60443-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386603520 | August Anthony Fiorini | Chiropractor | 4331 Lincoln Hwy, Ste. G, Matteson, IL 60443-2469 | 2006-03-17 |
| 1386261360 | Gia V Washington | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2020-06-25 |
| 1225696958 | Adrienne Lambert | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-29 |
| 1710544457 | Andrew Laberge | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-28 |
| 1235796236 | Mary K Aitchison | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-24 |
| 1346807435 | Patricia Salgado | Social Worker | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-05-23 |
| 1912470972 | Gena Goldman | Case Manager/Care Coordinator | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-01-02 |
| 1518430560 | Alexis Malkusak | Case Manager/Care Coordinator | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2019-01-02 |
| 1801254263 | Jessica Krakowsky | Counselor | 4331 Lincoln Hwy, Matteson, IL 60443-2404 | 2016-02-01 |
| 1780067983 | Lauren Sekula | Counselor | 4331 Lincoln Hwy, Suite E, Matteson, IL 60443-2404 | 2015-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
| 1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
| 1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
| 1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
| 1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
| 1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
| 1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
| 1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
| 1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
| 1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
| Find all providers in zip 60443 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639233174 | Grand Prairie Services | Clinic/Center | 21136 Keeler Ave, Matteson, IL 60443-2242 | 2006-12-20 |
| 1932442571 | Laynie Foundation | Clinic/Center | 4747 Lincoln Mall Dr, Suite 604, Matteson, IL 60443-3811 | 2013-04-02 |
| 1902982127 | Center Services Inc | Clinic/Center | 3624 W 216th Street, Matteson, IL 60443-2713 | 2006-10-31 |
| 1811073034 | Dyann Inc | Clinic/Center | 3624 W 216th Street, Matteson, IL 60443-2713 | 2006-10-31 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.